Washington County Memorial Hospital Improving Patient Experience

Washington County Memorial Hospital (WCMH) is a 25-bed, not-for-profit, Critical Access Hospital (CAH), providing acute care, swing bed, emergency medicine, rehabilitation therapies, imaging, lab, surgical services and primary care to the residents of Potosi, Missouri, and surrounding communities. WCMH also operates four rural health clinics (RHCs) and a robust specialty care clinic. Their mission is “to provide high-quality service and personable care to all we serve while seeking to improve the health and well-being of our community.” WCMH participated in a Quality of Care and Transition of Care Project in 2017.

Center staff spoke with Michele Meyer, president; Brianna East, administrative assistant; Laura Wells LPN, Director of Clinic Operations; Jenifer Ferguson RN, MSN, CHPQ, Director of Quality and Risk Management; Amber Coleman, Director of Support Services and Beverly Williams RN, BSN, CNO to discuss their project accomplishments and outcomes.

Q: What are some of your accomplishments on this project?

A: Concerning board education, the members completed a self-assessment of their knowledge of the future of rural health care. Missouri Hospital Association has education materials called “Govern Well” which will be disseminated on a regular basis.

To remain focused on quality reporting, scores and actions plans are posted on units so there is more transparency in sharing data. Dashboards for each department are created, posted and used to educate staff. There is more discussion about HCAHPS scores, so staff are more familiar with the questions. They have not begun to publicly post data within the hospital but will do so when staff is well educated. They are considering using social media to let the community know about patient experience areas in which they are doing well.

For patient rounding, the medical-surgical nurse manager rounds on every patient every day and the physicians and charge nurse round. The pharmacist often rounds with doctors as well. The CNO rounds on staff and shares results in huddles.

To improve patient communication, in April WCMH rolled out patient information binders and includes standard information, who to contact for what, patient portal information, TV channels, advance directives, pen and notebook, patient portal information, and follow up numbers that may be needed. In March, education was provided to nursing and staff gave input about the tabs and contents. The hospital was committed to providing an effective product for the patient while minimizing additional work for staff. Patients are encouraged to take this binder to follow up appointments with their PCP and to any visits to the emergency department or clinic. To maximize use of the binders, a picture of the binder is hung in the clinic and a social media push was done to remind patients. Providers report they are seeing more patients bring their binders to appointments!

In this transition of care project, WCMH focused on providing more information to the community about swing bed. Information is posted on Facebook, stories and testimonials are published and leadership present at community meetings and church groups when possible. They participated in National Senior Health Day and had booths set up through the hospital and scheduled wellness exams. “Eggs and Education” is a monthly breakfast for seniors and includes a special speaker. WCMH is working diligently on “increasing public face.”

And finally, WCMH created and hosts “Joint Health Partners” meeting. This collaborative meeting includes the FQHC, health department and EMS. The agenda includes a roundtable about updates on service lines and communication issues among them. The goal is to avoid duplicating resources and to make the most of the services they do have. These groups plan to work together on an upcoming community health needs assessment.

Q: What has been the impact of this project on WCMH?

A: Measurable outcomes include:

• Completion of Emergency Department Transfer Communication (EDTC) goal was met, moving from 78% to 91%
•  “Patients who reported that YES, they were given information about what to do during their recovery at home” goal was met increasing from 82% to 89%
• “Patients who strongly agree they understood their care when they left the hospital” increased from 34% to 44%

Non-measurable impact includes:

• Sharing of information has led to leaders “being on the same page” as frontline staff
• Leaders and staff have a better understanding of scores
• Patients are more involved in their own care because of use of binders and some are using that info when they see providers
• The organization thinks differently about impacting quality

Q: Lastly, how do you believe this project has helped you move forward in the newly emerging system of health care delivery and payment?

A: This project helped to create more meaningful, soft handoffs for patients that will decrease readmission rates; patients are getting more of what they need. WCMH is part of an ACO so there is a focus on wellness and preventative appointments rather than episodic care. This is aligned with the SRHT project goals.